Zoira Hanafi stood in shock as four doctors rushed behind her to enter the ward where her eight-month-old daughter Hambali lay semi-conscious.
Upon entering the Kayita Community Health Center in Nigeria’s northern Katsina state, medical personnel used color-coded tape to measure the diameter of children’s hands and determine their level of malnutrition. A steady stream of mothers, some as young as 15, filter in with children, many of whom, like Hambali, are in critical condition.
Children are victims of the unprecedented hunger crisis that has gripped large parts of Nigeria. The Red Cross has warned that up to 33 million Nigerians will face extreme hunger this year, a record number. According to the United Nations Office for the Coordination of Humanitarian Affairs, about 6.4 million Nigerian children are expected to be severely malnourished by the end of 2026, with the majority in the north.
According to Dr Soma Bhunan, Nigeria Mission Chief for the International Medical Action Alliance (Alema), which runs the Kaita facility alongside local authorities, an increasing number of mothers are also suffering from severe malnutrition.
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Clockwise from top left: A family walks in front of Alima Medical Center in Kaita. A woman sits waiting for her baby to be weighed. A medical worker stands between two rows of hospital beds at Elma Medical Center; A doctor reviews the documents. Locals say the 80-bed facility, funded by Alima and its donors since 2021, has been a lifesaver for people living nearby. Last year, the malnutrition program treated more than 36,000 children
Alima also supports mobile clinics that can reach children whose families cannot travel to Kaita, and can even facilitate transportation to the facility from the surrounding area.
But it faces an impossible challenge. Katsina state is at the center of Nigeria’s interstate hunger crisis, where long-term causes of food insecurity such as climate shocks and poor governance have been exacerbated by recent attacks by jihadists and other non-state actors that have cut off access to some communities, as well as increased short-term aid funding.
Nationwide, the doctor-patient ratio is approximately 1:9,000, much less than the 1:600 recommended by the World Health Organization. Thousands of doctors are fleeing abroad because of the delay in their meager salaries. Digital health startups and private sector partnerships have made inroads in big cities like Lagos and Abuja, but not elsewhere due to infrastructure deficiencies and inflation.
“Nigeria remains in a monetary crisis: economic/cost of living crisis, security crisis, human capital development crisis, human development crisis,” said Joachim McEbong, senior analyst at the Lagos-based office of Risk Control, a risk consultancy. “The four feed and amplify each other.”
Bhavanan said that “even with the results we are seeing in Kaita, the wider situation is very worrying”.
In non-profit circles, strategizing has begun to combat increased risk during the upcoming crop season, which runs from June to September.
Last year, the Nigerian government partnered with the World Bank to provide basic nutrition packages to millions of vulnerable families under the Accelerating Nutrition Outcomes in Nigeria project. The second phase is now underway.
Still, experts say there is a need for increased food security and social protection for vulnerable families, along with continued investment in maternal nutrition.
The key to this is organizing the supply chain for drugs and equipment. Peter Burner Jr., head of growth at Field Intelligence and a health technology company working on pharmaceutical supply chains in Africa, said it needed to “deal with the changes. [that are] happening globally”.
“For everyday people, that is [dire supply chain situation] Traveling long distances translates only to the fact that the medicine they need is not available, or substitutes with whatever is accessible, often at great cost,” he said. “What makes this especially acute in times of hunger crisis are the compound effects: malnutrition weakens the immune system, while the demand for treatment increases while the supply chain is strained.”
In 2018, Field Intelligence launched the Nigeria Health Logistics Management Information System, the country’s first such system, to track information related to the drug supply chain for public health initiatives. UNICEF recently joined the platform, which is now managed by the Ministry of Health, and Binor hopes other organizations will follow suit “so shortages can be anticipated and addressed before a crisis occurs”.
Aid workers also hope that the health sector – on the sharp end of foreign aid cuts – gets attention from the Nigerian government soon.
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Clockwise from top left: A whiteboard lists monthly patient statistics, including admissions, transfers, deaths and referrals, at the Alema facility in Kaita; Women sit and wait in facilities outside the building; A young man is sitting outside in the waiting area. Three women sit on hospital beds with their children at a center in Elma.
In the 2025 federal budget, the health sector was allocated about 5.2% of the total budget of 47.9 trillion naira. For years, the budget has been below 15% of the Abuja Declaration target agreed by African Union member states. This is the lowest per capita expenditure on health in the entire continent.
In February, Nigerians were shocked when the Minister of Health, Mohammed Ali Pat, announced that of the 218 billion naira (£119.6m) budget allocated for operations and capital projects overseen by the ministry’s headquarters, only 36 million naira (£9,751) – just 0.0165% – had been released.
“It’s a figure that tells its own story,” McEbbong said. “There are saloon cars from 2023 that are more expensive.”
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